Nerune Savitri M, Rao H R Sohan, Pallavi K, Lavate Amogh P, Das Sayandeep K, Pagi Sajal
Pathology, Shri B.M. Patil Medical College Hospital and Research Centre, Bijapur Lingayat District Educational (BLDE) Association (Deemed to be University), Vijayapura, IND.
Pathology, Central Referral Hospital, Sikkim Manipal Institute of Medical Sciences, Gangtok, IND.
Cureus. 2024 Sep 12;16(9):e69244. doi: 10.7759/cureus.69244. eCollection 2024 Sep.
Background Anemia is a widespread, worldwide hematological disorder, with iron deficiency anemia (IDA) and thalassemia trait (TT) being two frequently encountered forms. For effective management, it is vital to distinguish between these two conditions. Existing diagnostic methods have some limitations due to their inaccessibility and high cost. This study aims to evaluate novel hematological indices for distinguishing IDA from TT, offering potential improvements in diagnostic accuracy and patient care. Objective To compare the efficacy of novel hematological indices in differentiating IDA from TT, and to assess their sensitivity and specificity in clinical practice. Methods This cross-sectional observational study included 80 anemia patients (40 diagnosed cases of IDA and 40 of TT each). Hematological parameters were measured using the Sysmex XN-1000 analyzer (Sysmex Corporation, Kobe, Japan), and statistical analysis was conducted using the Mann-Whitney test, Pearson correlation coefficient (r), and correlation matrix. Results Significant differences were observed between IDA and TT patients in the indices studied. The Green and King Index demonstrated high diagnostic accuracy, with a sensitivity of 90% and specificity of 82%. The red cell distribution width (RDW) Index exhibited similar diagnostic performance, with a sensitivity of 90% and specificity of 77%. The England and Fraser Index showed a sensitivity of 85% and specificity of 80%, with a large effect size (r = -0.60). The correlation matrix revealed strong associations between key parameters, including a negative correlation between hemoglobin and RDW Index (r = -0.61) and a positive correlation between mean corpuscular volume (MCV) and Shine and Lal Index (r = 0.82). On the other hand, our study found that indices like Shine and Lal and Srivastava had limited diagnostic value, with smaller effect sizes (r = 0.28 and r = -0.005, respectively). Conclusion Hematological indices, such as the Green and King, RDW, and England and Fraser indices, show strong potential for differentiating IDA from TT, with high sensitivity, specificity, and large effect sizes. The correlation matrix further supports the diagnostic utility of these indices. These tools can enhance diagnostic precision in resource-limited settings and improve patient outcomes.
贫血是一种在全球范围内广泛存在的血液系统疾病，缺铁性贫血（IDA）和地中海贫血特质（TT）是两种常见类型。为了进行有效的管理，区分这两种情况至关重要。现有的诊断方法由于难以获取且成本高昂而存在一些局限性。本研究旨在评估用于区分IDA和TT的新型血液学指标，以期在诊断准确性和患者护理方面取得潜在改善。
比较新型血液学指标区分IDA和TT的效能，并评估其在临床实践中的敏感性和特异性。
这项横断面观察性研究纳入了80例贫血患者（每组40例确诊的IDA患者和40例TT患者）。使用Sysmex XN - 1000分析仪（Sysmex公司，日本神户）测量血液学参数，并采用曼 - 惠特尼检验、皮尔逊相关系数（r）和相关矩阵进行统计分析。
在研究的指标中，IDA患者和TT患者之间观察到显著差异。格林和金氏指数显示出较高的诊断准确性，敏感性为90%，特异性为82%。红细胞分布宽度（RDW）指数表现出类似的诊断性能，敏感性为90%，特异性为77%。英格兰和弗雷泽指数的敏感性为85%，特异性为80%，效应量较大（r = -0.60）。相关矩阵揭示了关键参数之间的强关联，包括血红蛋白与RDW指数之间的负相关（r = -0.61）以及平均红细胞体积（MCV）与施内和拉尔指数之间的正相关（r = 0.82）。另一方面，我们的研究发现施内和拉尔指数以及斯里瓦斯塔瓦指数等指标的诊断价值有限，效应量较小（分别为r = 0.28和r = -0.005）。
格林和金氏、RDW以及英格兰和弗雷泽等血液学指标在区分IDA和TT方面显示出强大潜力，具有高敏感性、特异性和较大效应量。相关矩阵进一步支持了这些指标的诊断效用。这些工具可以提高资源有限环境下的诊断精度并改善患者预后。
